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I had been wondering about this.  India was THE disaster zone of Covid.  What happened?  Can the Philippines or other poor tropical countries learn anything?  You would think their success would be all over the news.  Google it and really nothing comes up.

It seems that a majority of most new cases and deaths are in a small state called Kerala.  I wonder why?  They only have 3% of the population but over 50% of the new cases.

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https://www.reuters.com/world/the-great-reboot/keralas-covid-19-lessons-india-modis-government-2021-08-26/

MALAPPURAM, India, Aug 26 (Reuters) - Vilified by Indian Prime Minister Narendra Modi's party for its high COVID-19 cases, Kerala's apparent poor record may actually hold crucial lessons for the country in containing the outbreak as authorities brace for a possible third wave of infections.

The opposition-ruled, densely populated southern state is currently reporting the most number of coronavirus cases in the country and accounts for the second-highest national tally - unflattering headline numbers that Modi's Bharatiya Janata Party (BJP) has seized upon as a reflection of bungled local leadership.

However, a Reuters analysis of national and state data, and interviews with epidemiologists and Kerala health authorities paint a different picture.

It shows the state's containment measures have helped to catch infections early, allowing authorities to better manage the illness and dramatically lower the death rate - a stark contrast to people dying in carparks and outside hospitals for lack of oxygen and beds in big cities like Delhi at the height of the health crisis a few months earlier.

"While the federal government may have its views on rapid antigen tests, it is important to consider that the state's strategies have by and large succeeded in not just keeping mortality low but also in being able to detect one in six cases compared to one in 33 nationally," said Rajib Dasgupta, head of the Centre of Social Medicine & Community Health at New Delhi’s Jawaharlal Nehru University.

The efficient detection rate and its population density at more than twice the national average explain the high number of cases in Kerala.

All the same, at 0.5%, Kerala still has the lowest fatality rate among all but one thinly populated state. The national figure is 1.4% and it is 1.3% for the country's most populous state, Uttar Pradesh.

Reuters Graphics
Reuters Graphics

The difference comes down to Kerala's reliance on rapid antigen tests to detect and strictly isolate infected people at home, an approach the federal health ministry has sharply criticised but which state officials argue has helped them to better allocate hospital beds and oxygen supplies for those who really need them.

The government-recommended RT-PCR tests are more accurate but take longer to produce results, meaning by the time a positive COVID-19 case is confirmed the infected person is more likely to have developed severe symptoms and passed it on to others in a vicious cycle of more infections and deaths.

 

Kerala's rapid test results allow for early treatment in home isolation which then narrows the virus' path to infections, state officials say.

These factors, along with the strained medical resources across much of India, largely explain why the overall national death rate is much higher than in the Communist-run state.

 

Kerala officials also say a state-run support service that includes phone consultation, provision of drugs and pulse oximeters that detect blood oxygen levels for people recovering at home provide a bulwark in the battle against the disease.

Delhi had a similar support structure but it collapsed when cases surged.

 

"We do have a different model and our fatality rate shows our model is on the right track," Kerala Health Minister Veena George told Reuters.

But Kerala officials acknowledge that the fast-evolving pandemic can undo even the best thought-out plans unless authorities remain nimble and flexible.

 
Reuters Graphics Reuters Graphics
Reuters Graphics Reuters Graphics

A MODEL TO EMULATE?

 

When Reuters recently visited Kerala's most populous Malappuram district, which is reporting the greatest number of infections in India, a quarter of the 344 COVID beds in its biggest hospital were vacant and oxygen supply was ample.

The Indian Council of Medical Research has recommended lockdowns for districts where more than 10% of the tests return positive results. The rate is about 15% for Kerala and even higher in Malappuram, but shops and restaurants are open for business.

 

Kerala officials argue that they are able to keep businesses open as the state has the best testing rate among Indian states - 86 tests per 100 people, compared with about 33 in Uttar Pradesh- meaning they are able to catch infections early and ensure timely treatment.

Reuters Graphics
Reuters Graphics

The model, epidemiologists say, can be replicated in few other states with good health facilities, such as neighbouring Tamil Nadu.

"Their surveillance is good, they detect cases early and their testing is very focused," M.D. Gupte, a retired director of the National Institute of Epidemiology who advises the federal government on immunisations, said about Kerala.

 

"Most people in Kerala are educated, so that helps."

India’s daily demand for medical oxygen jumped more than eight times in May from pre-pandemic levels, but Kerala avoided major shortages of hospital beds and oxygen that crippled many states when nationwide infections saw an explosive surge.

The federal health ministry did not respond to emails requesting comment.

VACCINE PUSH

Minister George said the state was on course to administer at least one vaccine dose to all adults by next month, the fastest pace among all states. Currently, the state has covered more than 55% of adults with at least one vaccine dose, compared with 48% for the whole of India, which wants to vaccinate all its adults by December.

Kerala, with 35.5 million people, has so far reported 3.8 million infections, or 12% of India's total of 32.5 million. Its 19,757 deaths, however, account for only 4% of the overall nationwide fatalities.

The Indian government recommends 70% of all COVID-19 tests be carried out by the RT-PCR method, while Kerala's rate is less than 50%.

"This is not the Kerala model, this is a model of mismanagement," BJP President Jagat Prakash Nadda, India's former health minister, said last week.

He said BJP-ruled Uttar Pradesh and Madhya Pradesh had better managed the pandemic, though a government survey estimated in July that more than 70% residents of both states had been exposed to the virus. The figure was 44% for Kerala.

Kerala's COVID-19 hospitalisation rate is only about 3%, a state official said, compared with more than 5% nationwide when cases peaked in May.

T.S. Anish, a member of Kerala's COVID Expert Committee, said the state was now focused on vaccination.

"If you are able to vaccinate large numbers, you will get infections but your health system will not be overwhelmed."

Reporting by Krishna N. Das; Additional reporting by Chris Thomas and Jose Devasia Editing by Shri Navaratnam
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5 hours ago, OnMyWay said:

I had been wondering about this

Here is my conspiracy theory.....

As the West is emerging from the pandemic and getting back to normal as usual the media will be more focused on stories that effect. In the States it is about inflation, crt and jab mandates right now. The death toll in India does not sell.

#2. Looking Kerala up on wiki,,,,it seems to be one of the more affluent areas of India so more folks can afford to get tested, reported and treated.....while those who get infected and die in the hinterlands it is more, "oh well"

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After a quick search around the internet it appears that the main reason for the dramatic drop is that so many in India developed antibodies after being exposed to the virus may have helped. 

Also stated due to the virus not thriving in warmer weather outside the body the northern hemisphere's hotter weather over the mid-year period probably contributed in addition to India's inherently hotter weather year-round.

Personal discipline with regards to mask wearing and social distancing has also been attributed to the drop in case numbers; there were some comparatively heavy fines for not doing so, well by Indian standards anyway.  There were no national lockdowns as such after the initial response. 

All of the above was conjecture in the articles I read and for the most part, the scientists are scratching their heads and unable to pinpoint a single factor. 

 

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Maybe the same plan as these guys.

https://www.fox29.com/news/amish-community-in-lancaster-county-reaches-herd-immunity-from-covid-19-medical-center-says

(There is a video on the page but I cannot see how to link to it so have to go to the link and watch the video if you want)

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6 minutes ago, Dave Hounddriver said:

Maybe the same plan as these guys.

Dave, My pecadillo about this whole thing is how the media plays down comorbidities. 

Google "Amish" and hit images....you really don't see a lot of obese, out of shape Amish folks :whistling:

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1 hour ago, scott h said:

Google "Amish" and hit images....you really don't see a lot of obese, out of shape Amish folks :whistling:

Google "people in rural India" and hit images....you really don't see a lot of obese, out of shape Indian folks.

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3 minutes ago, Dave Hounddriver said:

Google "people in rural India"

Or balanced nutritious diets, clean running water or overall healthy living conditions :thumbsup:

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1 hour ago, Dave Hounddriver said:

Maybe the same plan as these guys.

https://www.fox29.com/news/amish-community-in-lancaster-county-reaches-herd-immunity-from-covid-19-medical-center-says

(There is a video on the page but I cannot see how to link to it so have to go to the link and watch the video if you want)

Here's a link the video:

 

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3 hours ago, Joey G said:

https://www.reuters.com/world/the-great-reboot/keralas-covid-19-lessons-india-modis-government-2021-08-26/

MALAPPURAM, India, Aug 26 (Reuters) - Vilified by Indian Prime Minister Narendra Modi's party for its high COVID-19 cases, Kerala's apparent poor record may actually hold crucial lessons for the country in containing the outbreak as authorities brace for a possible third wave of infections.

The opposition-ruled, densely populated southern state is currently reporting the most number of coronavirus cases in the country and accounts for the second-highest national tally - unflattering headline numbers that Modi's Bharatiya Janata Party (BJP) has seized upon as a reflection of bungled local leadership.

However, a Reuters analysis of national and state data, and interviews with epidemiologists and Kerala health authorities paint a different picture.

It shows the state's containment measures have helped to catch infections early, allowing authorities to better manage the illness and dramatically lower the death rate - a stark contrast to people dying in carparks and outside hospitals for lack of oxygen and beds in big cities like Delhi at the height of the health crisis a few months earlier.

"While the federal government may have its views on rapid antigen tests, it is important to consider that the state's strategies have by and large succeeded in not just keeping mortality low but also in being able to detect one in six cases compared to one in 33 nationally," said Rajib Dasgupta, head of the Centre of Social Medicine & Community Health at New Delhi’s Jawaharlal Nehru University.

The efficient detection rate and its population density at more than twice the national average explain the high number of cases in Kerala.

All the same, at 0.5%, Kerala still has the lowest fatality rate among all but one thinly populated state. The national figure is 1.4% and it is 1.3% for the country's most populous state, Uttar Pradesh.

Reuters Graphics
Reuters Graphics

The difference comes down to Kerala's reliance on rapid antigen tests to detect and strictly isolate infected people at home, an approach the federal health ministry has sharply criticised but which state officials argue has helped them to better allocate hospital beds and oxygen supplies for those who really need them.

The government-recommended RT-PCR tests are more accurate but take longer to produce results, meaning by the time a positive COVID-19 case is confirmed the infected person is more likely to have developed severe symptoms and passed it on to others in a vicious cycle of more infections and deaths.

 

Kerala's rapid test results allow for early treatment in home isolation which then narrows the virus' path to infections, state officials say.

These factors, along with the strained medical resources across much of India, largely explain why the overall national death rate is much higher than in the Communist-run state.

 

Kerala officials also say a state-run support service that includes phone consultation, provision of drugs and pulse oximeters that detect blood oxygen levels for people recovering at home provide a bulwark in the battle against the disease.

Delhi had a similar support structure but it collapsed when cases surged.

 

"We do have a different model and our fatality rate shows our model is on the right track," Kerala Health Minister Veena George told Reuters.

But Kerala officials acknowledge that the fast-evolving pandemic can undo even the best thought-out plans unless authorities remain nimble and flexible.

 
Reuters Graphics Reuters Graphics
Reuters Graphics Reuters Graphics

A MODEL TO EMULATE?

 

When Reuters recently visited Kerala's most populous Malappuram district, which is reporting the greatest number of infections in India, a quarter of the 344 COVID beds in its biggest hospital were vacant and oxygen supply was ample.

The Indian Council of Medical Research has recommended lockdowns for districts where more than 10% of the tests return positive results. The rate is about 15% for Kerala and even higher in Malappuram, but shops and restaurants are open for business.

 

Kerala officials argue that they are able to keep businesses open as the state has the best testing rate among Indian states - 86 tests per 100 people, compared with about 33 in Uttar Pradesh- meaning they are able to catch infections early and ensure timely treatment.

Reuters Graphics
Reuters Graphics

The model, epidemiologists say, can be replicated in few other states with good health facilities, such as neighbouring Tamil Nadu.

"Their surveillance is good, they detect cases early and their testing is very focused," M.D. Gupte, a retired director of the National Institute of Epidemiology who advises the federal government on immunisations, said about Kerala.

 

"Most people in Kerala are educated, so that helps."

India’s daily demand for medical oxygen jumped more than eight times in May from pre-pandemic levels, but Kerala avoided major shortages of hospital beds and oxygen that crippled many states when nationwide infections saw an explosive surge.

The federal health ministry did not respond to emails requesting comment.

VACCINE PUSH

Minister George said the state was on course to administer at least one vaccine dose to all adults by next month, the fastest pace among all states. Currently, the state has covered more than 55% of adults with at least one vaccine dose, compared with 48% for the whole of India, which wants to vaccinate all its adults by December.

Kerala, with 35.5 million people, has so far reported 3.8 million infections, or 12% of India's total of 32.5 million. Its 19,757 deaths, however, account for only 4% of the overall nationwide fatalities.

The Indian government recommends 70% of all COVID-19 tests be carried out by the RT-PCR method, while Kerala's rate is less than 50%.

"This is not the Kerala model, this is a model of mismanagement," BJP President Jagat Prakash Nadda, India's former health minister, said last week.

He said BJP-ruled Uttar Pradesh and Madhya Pradesh had better managed the pandemic, though a government survey estimated in July that more than 70% residents of both states had been exposed to the virus. The figure was 44% for Kerala.

Kerala's COVID-19 hospitalisation rate is only about 3%, a state official said, compared with more than 5% nationwide when cases peaked in May.

T.S. Anish, a member of Kerala's COVID Expert Committee, said the state was now focused on vaccination.

"If you are able to vaccinate large numbers, you will get infections but your health system will not be overwhelmed."

Reporting by Krishna N. Das; Additional reporting by Chris Thomas and Jose Devasia Editing by Shri Navaratnam

That article is from August and does not reflect the current situation.  On Oct. 30th, India has a 7 day average daily deaths of 560.  Kerala has 469 of them.  84% of the deaths and only 3% of the population.

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